Disorders of The Liver Flash Cards

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Title:	Disorders of The Liver
Description:	nursing lecture highlights on liver failure and related conditions
Number of Cards:	16
Save Count:	3
Author:	adrvsmith11
Created:	2002-03-04
Tags:	medicine
Private	No

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- Question
- Answer
- Side 3

- What are the manifestations of cirrhosis?
- chronic indigestion
  weight loss
  spleenomegally
  spider telangiectasis
  varices-d/t portal HTN
  decrease in albumin
  vitamin deficiency
  gastritis
  ascites
  caput medusae-enlarged vessels ATC belly button
  anemia
  coma
  encephalopathy
  bleeding
- What are the different types of cirrhosis?
- Laennac's-chronic ETOH
  Post necrotic-viral infection
  Biliary-scarring in bile duct
  Cardiac-CHF r/t engaged liver
  Early-liver large, cells loaded with fat
  LATE-liver size decreased as scar tissue contracts
- What do you assess?
- chief complaint
  GI-pain, anorexia, nausea, vomiting, wt. change, indigestion, fat intolerance, eructation, bowel changes, melena, clay colored stools, steatorrhea
  Neurologic-drowsiness, clouded sensorium, irritability, change in mental status
  GU-change in urine color (orange)
  Skin-jaundice, petechiae, dilate abdominal veins, unexplaine punctures
  CV-nosebleeds, bruising, hemorrhoids, ascites, edema
- Past Health HX
- major illness, hospitalizations
  procedures causing skin, membrane disruption
  medications
- What are the functions of the liver?
- glucose metabolism
  lipid metabolism
  protein metabolism
  vitamins and mineral levels
  drug metabolism and detoxification
  bile formation
  billirubin excretion
  blood volume reservoir
  blood filter
  blood clotting
  hormone detoxification
- What do radiologic exams tell you?
- structure
- What are the complications of paracentisis?
- hypovolemia and shock
- What are the interventions used to treat ascites?
- d/c meds that dec. prostaglandins
  diuretics, esp. aldactone
  IV albumin
  low na diet
  restrict fluids
  paracentisis
  pertioneovenous shunt
- What is ascites?
- sequel to portal HTN
  fluid accumulation in peritoneal cavity
  chronic problem-liver sweats
- What are the contraindications of a liver biopsy? What are some complications?
- CONTRAINDICATIONS:
  thrombocytopenia
  prolonged PT
  peritonitis
  mass axcites
  enlarged gallbladder
  cancer
  COMPLICATIONS:
  hemorrhage
  pneumothorax
  infections
  peritonitis
- What are some nursing intervetions used in treating ascites?
- daily weights
  girth measurements
  strict I&O
  small frequent feedings
  limit protein and fluids
  teach to read food labels-NA
  skin care
- What is hepatic encephalopathy?
- results from accumulation of ammonia and other toxic metabolites in blood
  damaged liver cells fail to detoxify and convert to urea the ammonia that is constantly entering bloodstream
- Diagnostic Exams
- ALT (SGPT)-liver specific
  AST
  ALP
  LDH-#4&5
  Billirubin-conjugated vs onjugated
  PT-prolonged in liver failure
  Serum ammonia-inc. r/t no breakdown and elimination
  Serum albumin-r/t dec. urea production
  globulins-dec. related to dec. production except with cirrhosis initially
- What are the causes that result in damage to liver parenchymal cells?
- infectious agents
  toxins
  nutritional deficiency
  cirrhosis
  anoxia
  medications
  hypersensitivity
- Medical management Hepatitis?
- bedrest
  diet of high CHO and low fat
  frequent small feedings
  IV if indicated
- What are the clinical manifestations of hepatic encephalopathy?
- minor mental and motor changes
  slight confusion, alteration in mood
  asterixis (hand flapping)
  handwriting changes
  LATE-frank coma